Cleaning And Disinfecting Soft Surfaces

This is the first part of a three-part article about cleaning and disinfecting curtains, couches, beds and other soft surfaces in healthcare facilities.

As executive housekeeper at Pine Crest Nursing Home, a 180-resident facility in Merrill, Wisconsin, Bruce Slaminski knows caring for his facility’s soft surfaces can prevent the spread of infection and disease.

He also knows firsthand the challenges associated with cleaning soft surfaces — difficulties he says have increased as nursing home care has expanded.

“A lot of people are coming in with [Clostridium difficile], which used to be an uncommon thing, but now it’s very common,” he says.

Infections related to antibiotic-resistant organisms, Norovirus and respiratory infections run rampant among nursing home patients. And, as a result, surfaces such as beds, privacy curtains, chairs, couches and more can often become soiled.

Slaminski has overseen housekeeping at Pine Crest for 18 years and worked at a hospital for 20 years before that. He says caring for soft surfaces is an essential element in any infection prevention and control program.

Isaac Johnson agrees on the importance of soft-surface care. He is regional director of operations for Crothall Healthcare, a building service contractor based in Wayne, Pennsylvania, that manages environmental services at Duke University Health System in Durham, North Carolina. Johnson oversees 48 managers and 600 frontline associates responsible for cleaning the 950-bed, 5.5-million-square-foot healthcare facility.

The campus-based facility has been a leader in soft surface care, but Johnson still admits it can be a difficult assignment.

“Soft surfaces present a challenge because of the frequency in which you’re able to clean them,” he says. “And some of the chemicals used to clean them are very harsh and can damage the very surfaces they are designed to clean.”

Hard Threats On Soft Surfaces

Just how much of a role do soft surfaces really play in spreading infections disease?

Plenty, says Darrel Hicks, the author of “Infection Control for Dummies.”

He refers to a study using Glo Germ, an infection contamination visual that shows how infection spreads in a patient room. The study revealed that the patient’s bed is the epicenter of contamination, with the patient being the source of the contamination. The patient gets a visitor, who sits on the bed briefly and then sits on a chair in the room. The visitor then transfers germs to the surface of the chair from the seat of his or her pants. A nurse comes in and checks the patient’s vitals, then closes the privacy curtain again when she leaves. Those germs now are on the curtain.

“It was a real ‘a-ha’ moment,” says Hicks of the study. “We suspected this went on, but when you see it in reality, it’s a different story. And, when you think about soft surfaces, the patient linens get washed, but you can’t do that with fabric on chairs or other soft surfaces, as well as the privacy curtains around the bed.”

The frequency in which soft surfaces are cleaned is also an issue for infection prevention. The standard for when cleaning is necessary is often “when visibly soiled,” says Hicks. This is in part because housekeeping departments are being asked to do more with less, and surveys showing staffing is down up to 15 percent in some facilities.

“When they are barely able to get the rooms cleaned daily, furniture cleaning is not top of mind,” says Hicks. “It often takes a project person to come in and clean it.”

Yet, these surfaces when tested are often covered with MRSA, Vancomycin-resistant Enterococcus and C. diff. It behooves all healthcare and long-term care facilities to make cleaning these surfaces regularly a priority, says Hicks.

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